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A test for Plan B

How accessible is the morning-after pill in Missoula?

After a more than 10-year battle waged by reproductive rights advocates to increase access to emergency contraception, commonly referred to as “the morning-after pill,” a federal judge ruled that the drug can be sold without a prescription to anyone, regardless of age. A recent investigation by the Independent, however, found that despite the April ruling, multiple issues hinder the ability of young people to access the pill in and around Missoula.

Prompted by a nationwide project called “Where is your Plan B?” launched this year by the Media Consortium on Reproductive Justice and the Association of Alternative News Media, the Independent visited seven area grocery stores and pharmacies last week and asked employees how to purchase emergency contraception.

Challenges obtaining the drug were most apparent during a visit to Safeway on West Broadway, where a pharmacy technician requested identification “to make sure you’re 18.” When we asked why, the employee explained that the rules are “still in the gray area right now.” A similar situation occurred at Lolo Drug, where pharmacist Ross Roadarmel said a customer would have to be “at least 18 years of age” before obtaining a generic morning-after pill.

The confusion stems from a series of changes in the rules. In 2009, the U.S. Food and Drug Administration dropped the age requirement to purchase emergency contraception from 18 to 17.
Further complicating things was the FDA’s June decision to grant one company, Teva Pharmaceuticals, the exclusive right to sell the drug without a prescription to individuals 17 and under. That decision means the only morning-after pill available to women under 17 without a doctor’s approval is Teva Pharmaceuticals’ Plan B One-Step.

click to enlarge

Cathrine L. Walters

A federal judge ruled in April that emergency contraception must be made available to women of all ages, but the pills can still be tough to obtain in Missoula.

The problem is not all stores stock Plan B One-Step. The Independent found that some pharmacies, including those at Safeway and Albertsons, only sell generic emergency contraception, such as “Next Choice.” Despite the federal judge’s April ruling, girls 16 and under who attempt to buy Next Choice without a prescription will be denied.

The Independent found further challenges obtaining emergency contraception at the Rosauers on Reserve Street. While the store sells Plan B One-Step and, as is required, doesn’t ask for proof of age, it keeps the pills behind the pharmacy counter, meaning the drug can be obtained only during pharmacy hours. On weekdays, it’s open from 9 a.m. to 8 p.m. It closes at 6 p.m. on weekends.

NARAL Pro-Choice Montana Executive Director Maggie Moran has concerns about some of the local practices and underlines the importance of making sure that emergency contraception remains available to women, regardless of age.

“We’re eliminating a lot of unintended pregnancies,” she says, “and then, of course, the decision later that a woman would have to make about whether or not to terminate that pregnancy.”

Moran sees a couple problems with stores choosing to keep contraception behind the pharmacy counter, like at Rosauers. While Plan B can be effective for up to 72 hours, ingesting it sooner increases the odds it will work. Rosauers’ protocol makes it tough for young women to access the drug quickly. Similarly, Moran says teenagers can feel shy about asking for birth control.

“Having them available and not having to ask for help from a pharmacist or a sales person in a store makes people much more likely to actually purchase them,” she says, “which means they’re much more likely to actually use them.”

Advocates such as Moran add that the FDA’s decision to grant an over-the-counter monopoly to TEVA’s Plan B puts low-income women at a disadvantage. Plan B, which runs on average $50 per pill, costs roughly 25 percent more than generic morning-after pills.

Ultimately, she says any lingering challenges make it clear that more work needs to be done to ensure that all women have access to reproductive freedom.

“We all have had experiences where, the next day, we think, ‘Oh man, I might have just put myself really at risk,’” she says. “And so, being able to get access to that medication right away is huge.”